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Practice topics Exam 1 > Infectious disease - TB and Hepatitis > Flashcards

Infectious disease - TB and Hepatitis Flashcards

1
Q

Infectious disease - definition

A

Clinically evident infection causing injury and clinical signs/symptoms

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2
Q

“communicable disease” definition

A

is one in which the pathogen may be transmitted from one person to another

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3
Q

Hepatitis is what

A

inflammation of the liver
most common cause of infectious hep in US is viral
significant amounts are unreported

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4
Q

Non-infectious hep aka

A

Nonviral

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5
Q

Non-infectious hep causes

A

Medication overdose - acetominophen, niacin
Toxins - carbon tetrachloride (freon)
Autoimmune disorder - multisystemic disease

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6
Q

Viral hepatitis description

A 
6 strains of viruses have been identified
3 of most common are 
- Hep A (infectious)
- Hep B (serum) 
- Hep C (non A, non B)
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7
Q

Hep A - chronic infection

A

NO - it does not have a chronic infection component to it

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8
Q

Hep B - chronic infection

A

YES

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9
Q

Hep C - chronic infection

A

YES

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10
Q

Hep A - how transmitted

A

feces, bile, blood, shellfish
ORAL - FECAL route of transmission
person to person contact

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11
Q

Hep A - incubation

A

30-45 days

Incubation means you are infected and can spread during this time

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12
Q

Hep A - onset

A

acute with fever

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13
Q

Hep A - contagious for how long

A

up to 3 months after onset of s/s

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14
Q

Hep A - prevention/treatment

A

Pre/post immunization

Hygiene

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15
Q

Hep A - mortality

A

Mortality rate is low - if do pass away, is likely due to something else going on

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16
Q

Hep B - how tranmitted

A

Blood, body fluids, contaminated needles

Often sexually transmitted

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17
Q

Hep B - incubation

A

60-180 days

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18
Q

Hep B - onset

A

insidious - often don’t know they are sick until months into the disease

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19
Q

Hep B - chronic

A

yes

up to 30% develop chronic hepatits

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20
Q

Hep B - prevention/treatment

A

pre-post immunization

interferon, antiviral meds

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21
Q

Hep B - mortality

A

1% develop fulminant hepatic failure with an 80% mortality rate!!!

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22
Q

Hep C - transmitted how

A

Most cases of transfusion hepatitis

Blood, infected needles

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23
Q

Hep C - Incubation

A

30-180 days

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24
Q

Hep C - onset

A

insidious

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25
Hep C - chronic
Yes! | up to 50-80% develop chronic hepatitis
26
Hep C - prevention/treatment
screening, modify risk bx | No immunizations for this!
27
Clinical presentation - ranges from
absence of s/s to liver failure and then coma and death
28
Clinical presentation - phase 1
incubation - hepatitis virus in stool
29
Clinical presentation - phase 2
prodromal - when people usually seek doctor Fatigue, anorexia, malaise, vomit, HA, cough, low fever, weight loss, abdominal pain Often misdiagnosed with gastroenteritis!!!
30
Clinical presentation - phase 3
Icteric (acute) | Jaundince, dark urine, discolored stool, hepatomegaly, tender liver, abdominal pain
31
Clinical presentation - phase 4
recovery - resolution of jaundice, symptoms diminish, liver may stay enlarged Liver will not shrink back to normal!
32
Complication - Fulminant hepatitis is what
CLinical syndrome with necrosis of liver cells jaundice, abdominal pain, anorexia, vomit are initial signs ascites and GI bleed in later stages
33
Complication - fulminant hepatitis - what is the outcome
necrosis of the liver is irreversible up to 90% of patients die need liver transplant!!!
34
Cirrhosis is what
irreversible inflammation causing fibrosis
35
Development of cirrhosis
multiple causes liver hypertension occurs at end stage often develops slowly but if toxins are involved it can progress quickly
36
Cirrhosis - effect on other systems
Hormone effects Metabolism effects Portal hypertension effects
37
Cirrhosis - effect on other systems - hormone
menstrual dysfunction hair loss spider angiomas edema
38
Cirrhosis - effect on other systems - metabolism
``` jaundice light colored stool bleeding tendency dark urine hypoglycemia ```
39
Cirrhosis - effect on other systems - portal hypertension effects
``` Ascites in the abdomen edema anemia leukopenia internal varices ```
40
Treatment summary for hepatitis
IMMUNIZATION for A and B Supportive tx Watch for complications
41
Chronic hepatitis - goal of tx is to
reduce liver inflammation and scarring
42
TB - timeline
``` 1865 - contagious 1882 - organism discovered 1884 - first sanatorium in US 1943 - drug discovered to tx (streptomycin) 1970 - sanatoriums closed 1980 - rise of TB cases (mid 1980s) 1993 - decline in TB ```
43
TB - overtime what has happened
overall decline but recent increase in the drug resistant TB | higher rates in port states
44
TB - demographics
most 24-63 yrs of age | M more than F
45
TB - causative pathogen
In US majority are by mycobacterium tuberculosis
46
TB - infectious process - how spread
it is spread through the air infection occurs when susceptible person inhales droplet nuclei containing tubercle bacilli and the droplet nuclei reaches the alveoli in the lungs Immune response can kill most bacilli, leading to formation of a granuloma
47
Latent TB
Not active disease Granuloma has been established Immune response controlled the infection Tests pos on the skin test (but they dont have disease and cant spread it)
48
Active disease - TB
Can be soon after infection or years later 5% who are infected will develop the disease within 1-2 yrs of the infection Another 5% will develop it sometime later Inc rate in those with dec immune response (ex - those with HIV)
49
TB infection vs. TB disease - for both of them
Tubercle bacilli in the body | Tubercle skin test usually positive
50
TB infection vs. TB disease - chest x ray
infection - normal | disease - abnormal
51
TB infection vs. TB disease - sputum smears and cultures
infection - negative | disease - positive
52
TB infection vs. TB disease - symptoms
infection - none | disease - cough, fever, weight loss
53
TB infection vs. TB disease - infectious
infection - not infectious | disease - often infectious before tx
54
TB infection vs. TB disease - case of TB?
infection - no | disease - yes and should be reported
55
TB classification system
``` 0 - no exposure, not infected 1 - exposure yes, no evidence of infection 2- infection yes, no disease 3 - TB case, clinically active 4 - TB case, not clinically active 5 - TB suspected ```
56
Risk factors for TB infection
``` Foreign born Travel Urban poor, homeless Military personnel Illicit drug use - injected Health care workers ```
57
Risk factors for TB disease
``` HIV infection Recent TB infection DM Sillicosis Prolonged corticosteroid use Immunosuppresive therapy Cancer Severe kidney dsease Intestinal conditions Low body weight ```
58
TB clinical manifestations
Cough with duration 3 weeks or more Chest pain Hemoptysis Systemic s/s - fever, chills, night sweats, appetite loss, weight loss, easy fatigability
59
TB - Extrapulmonary TB
common site - skeletal system - common is spine (Potts) | also now finding it in TMJ
60
TB intervention
PREVENTION! long term tx (3-12 months) Multiple drugs Directly observed therapy (DOT) preferred management strategy
61
TB goals of tx
Cure pt, minimize death and disability from TB | Interrupt transmission to other people
62
TB - drug therapy includes
``` Multidrug! First line = - isoniazid (INH) - Rifampin (RIF) - Ethambutol ``` Now seeing Pyrazinamide (PZA) for the drug resistant strain of TB

Practice topics Exam 1 (15 decks)

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